Immune-mediated inflammatory diseases (IMIDs) affect up to 7% of the global population, often striking during the prime of life.1 These complex conditions not only cause significant disability but also increase the risk of developing other IMIDs and systemic comorbidities like heart disease and mental illness. The impact on patients' quality of life is severe, and the burden on healthcare systems is immense.
Taiwan, like many nations, struggles to provide optimal care for IMID patients. The traditional siloed approach, where specialists work in isolation, often fails to address the diverse needs of these individuals. What's needed is a patient-centred, multidisciplinary model that empowers patients and promotes shared decision-making.
The Economist Impact report, "Patients at the heart: Taiwan’s journey to patient-centred care for Immune-Mediated Inflammatory Diseases," sponsored by Takeda, examines the care pathways for three major IMIDs in Taiwan: inflammatory bowel diseases, psoriatic diseases, and rheumatoid arthritis. The report identifies key areas for improvement and outlines a path forward:
1. Address inefficiencies in the care pathway:
- Given the paucity of sub-specialists and regional disparities in their distribution, improving access to diagnostic tests can effectively screen individuals with symptoms and prevent unnecessary referrals
- Implement e-health solutions inspired by global successful models to facilitate remote monitoring and timely interventions for patients experiencing flares
2. Develop integrated and cross-cutting solutions for IMIDs:
- Train specialist nurses with expertise in various IMIDs to bridge gaps in care and promote a more patient-centric approach
- Adapt successful multidisciplinary clinic models from the region to fit Taiwan's local needs
3. Adopt a multi-pronged approach to achieve Treat-to-Target (T2T):
- Leverage artificial intelligence to predict treatment responses and tailor therapies more effectively, minimising the trial-and-error approach
- Increase awareness among healthcare providers, improve guidelines, and enhance reimbursement policies to optimise existing treatments and encourage the development of new, more effective therapies
4. Transition to a value-based model of care to fulfil the unmet needs of patients:
- Collect Patient-Reported Outcome Measures (PROMs) and integrate them into electronic health records to enhance patient management and outcomes
- Engage patients in co-creating care models to further enhance the patient-centricity of the healthcare system
By implementing these strategies, Taiwan can enhance the quality of IMID care and improve outcomes for those living with these challenging conditions. The time for action is now.
References
1Chen HH, Chao WC, Chen YH, et al. Risk of immune-mediated inflammatory diseases in newly diagnosed ankylosing spondylitis patients: a population-based matched cohort study. Arthritis Res Ther. 2019;21(1):196